Mumbai diabetic retinopathy study WDF08-338

The project seeks to determine the prevalence of diabetic retinopathy and to perform counseling and treatment of people with diabetes in urban slum areas in Maharashtra State, India.

Objectives & approach

India is experiencing a rising burden of people with diabetes. This increases the risk of more people suffering from severe eye complications which may lead to irreversible blindness if not properly managed.

Currently, India is the country with the second highest number of people living with diabetes. 50,7 million people are estimated to suffer from diabetes, a number that is expected to increase rapidly during the next few decades. Unfortunately, a lot of the people living with diabetes are unaware of their condition and untreated complications of diabetes can entail severe consequences, with one of them being blindness.

ObjectiveThe project seeks to determine the prevalence of diabetic retinopathy and to perform counseling and treatment of people with diabetes in urban slum areas in Maharashtra State, India.

ApproachThe project is being implemented in the urban slums of Mumbai, Thane and Raigad districts, all situated in the western part of Maharashtra State, India. Implementation is managed by Aditya Jyot Eye Hospital with assistance from other local partners. The World Diabetes Foundation is funding another project (WDF08-319) with focus on diabetic retinopathy that is situated in the Vidarbha region in the eastern part of the Maharashtra State.

The overall goal of reducing blindness caused by diabetes will be reached by using several components.

Awareness

Awareness of diabetes and its risk factors is the first step in combating the increasing rate of blindness. By informing people of early signs of diabetes and encouraging screening for diabetes as well as for eye problems it is expected that the amount of people going blind due to untreated diabetic retinopathy will decrease.

A total of 160 awareness camps will be organised in 35 wards by medical social workers. Attention about the awareness camps will be generated through pamphlets, posters and banners in the local settings. Through the camps, people will be informed about diabetes, its risk factors and they will be encouraged to participate in the screening camp the day after the awareness camp.

Screening

A team consisting of a retina specialist, an optometrist and a research coordinator will conduct screening camps. Participants with indicators for risk of diabetes and people already diagnosed with diabetes will have their eyes examined by an ophthalmologist or a retina specialist. People detected with diabetic retinopathy needing counseling will be referred to treatment and care at the Aditya Jyot Eye Hospital. Furthermore, all people detected with diabetes will be encouraged to participate in a consultation with a diabetologist for education and management of the disease.

It is estimated that around 22,400 people will be participating in these awareness and screening camps. They will be screened and counseled on issues related to diabetes.

Local NGOs will assist in disseminating information about awareness camps, diabetes in general and prevention of diabetes. During the screening camps they will help screen for diabetes. By involving the local NGOs the partner is ensuring sustainability after project completion. The NGOs are expected to continue organising awareness as well as screening camps on a regular basis.

In a low-income country as India, access to diabetes care is often problematic. Therefore, a mobile van will visit a minimum of 10 places in the districts of Thane and Raigad. The van will be equipped with instruments to perform eye screening on people detected with diabetes. People in need of treatment will be brought to an eye clinic in Thane or to the main hospital Aditya Jyot Eye Hospital, where they will receive laser treatment or if required vitreo-retinal surgery.

Training

To enhance knowledge about diabetes and its complications, physicians and ophthalmologists will provide training sessions for medical social workers. However, special attention will be on diabetic retinopathy. Afterwards, the medical social workers will be able to provide counseling on prevention and healthy lifestyle to people with diabetes. The medical workers will furthermore be involved in the follow-up process that involves keeping track of patients and reminding them of their follow-up meetings. They will use postcards to reach out to the patients or visiting them if they are in the area.